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Forever alone disorder

Valentines Day is soon upon us. However, quite a few individuals, also known as otakus, could care less. During college I met some people who you might consider otakus or dorks. They never left their dorm rooms because they were just THAT into their video games. They would play for hours/days, completely disinterested in socializing with real people, partying, attending classes, and sometimes even eating. Although I didn't know it at the time, there was a name for this kind of strange and extreme "loner" behavior. For those of you who are unfamiliar with hikikomori, it is a recently recognized type of mental illness that has been rampant in locations like Japan. It refers to adolescent or young adult males who completely withdraw from social life and remain completely isolated, typically staying in their rooms for months on end. The criteria include:

1) spending most of the day and nearly every day confined to home 2) marked and persistent avoidance of social situations 3) symptoms interfering significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships 4) perceiving the withdrawal as ego-syntonic5) duration at least six months 6) no other mental disorder that accounts for the social withdrawal and avoidance.

It is quite a serious issue and is linked to autism, pervasive developmental disorder, societal and cultural influences.

I have heard of some cases happening here in the US and Spain as well. Ovejero and colleagues (2013) provide a case study in which a young Spanish man was socially isolated for four years. He kept his room in an orderly fashion, was well groomed, and kept active within his home (although the article does not specify how he spent his time, I would put my money on World of Warcraft). There was no evidence of any other psychological disorder (e.g. schizophrenia, social phobia, anxiety, depression). The man stated that he was ashamed to leave his room because he had no teeth. He explained that his fear of needles prevented him from receiving dental prostheses.

Below are some videos that nicely depict hikikomori. The first video is an illustration as to what the life of an individual "suffering" from hikikomori may look like.The second video is a commentary on hikikomori. The critical question that I have in mind is whether hikikomori should really be considered a disorder since the individual isn't really suffering per se. They actually quite enjoy being by themselves. Perhaps the "disorder" is due to the fact that they are not "productive" citizens of society. However, what if they were able to generate an income through something like internet services? I've heard of people who make a living by playing video games and streaming their performance live while receiving donations from dedicated viewers and fans (twitch.tv).